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Computed tomogram myelography in cervical spondylosis.

D A Boot, R H Khan, R J Sellar

    International Orthopaedics
    |January 1, 1987
    PubMed
    Summary

    CT myelography offers superior detail for cervical spondylosis compared to traditional myelography. This advanced imaging technique better identifies spinal stenosis and joint involvement, aiding surgical planning for severe cases.

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    Area of Science:

    • Neurosurgery
    • Radiology
    • Orthopedic Spine Surgery

    Background:

    • Cervical spondylosis presents with severe, prolonged symptoms requiring accurate diagnostic evaluation.
    • Conventional imaging methods like plain radiography and myelography have limitations in visualizing degenerative changes.
    • Patients considered for anterior cervical spine surgery need detailed assessment of spinal canal and foraminal compromise.

    Purpose of the Study:

    • To evaluate the diagnostic efficacy of CT myelography in patients with severe cervical spondylosis.
    • To compare the findings of CT myelography with conventional myelography and surgical outcomes.
    • To determine the utility of CT myelography in surgical planning for anterior cervical spine fusion.

    Main Methods:

    • Nine patients with severe cervical spondylosis underwent myelography followed by CT myelography using a single intrathecal contrast injection.

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  • Pre-procedural evaluations included clinical assessment, electromyography (EMG), and plain radiography.
  • Surgical findings were correlated with pre-operative imaging results.

    • Main Results:

    • Plain radiography showed multi-level degenerative changes in all patients.
    • EMG indicated multi-level compression in three patients but failed to localize a single level.
    • CT myelography provided detailed visualization of Luschka joint involvement, facet joint issues, foramen encroachment, and spinal stenosis, correlating closely with surgical findings in three patients.
    • Conventional myelography showed significant indentation in some cases but failed to detect osteophytes or root compression effectively.

    Conclusions:

    • CT myelography is a valuable tool for assessing the degree of spinal stenosis and degenerative changes in cervical spondylosis.
    • It offers superior detail compared to conventional myelography, particularly in identifying osteophytes and foraminal narrowing.
    • CT myelography findings correlate well with surgical outcomes, improving surgical planning for anterior cervical spine procedures.